2025/26 Seasonal Influenza Vaccination (SIV) School Outreach Programme - Frequently Used Forms for Participating Schools

Enrolment &
Selection of Doctor/ Medical Organisation

Enrolment Form
Supplementary Form

Before vaccination

SIVSO_S_A1(KG)

SIVSO_S_A1(PS)

SIVSO_S_A1(SS)

The Number of Students Consented to Vaccination of Each Class
- For KG/ CCC

- For Primary School

- For Secondary School

SIVSO_S_A2

Notice to Parents One Week before the First Dose of Vaccination Day

-Sample For Primary School & KG/CCC

-Sample For Secondary School

SIVSO_S_A3

Notice to Parents One Week before the Second Dose of Vaccination Day (Sample)

Seasonal Influenza Vaccine Consent Form

- Injectable Vaccine

- Nasal Spray Vaccine

- Injectable Vaccine or Nasal Spray Vaccine

Consent Form Sample

Vaccine recipient has already registered eHealth

Vaccine recipient has not registered or is unsure of his or her eHealth registration status
- Vaccine recipient aged 18 or above

- Vaccine recipient between the age of 16 and less than 18 years

- Vaccine recipient aged under 16, or aged 16 or above but incapable of giving consent

SIVSO_D_A2

Consent Forms Receipt Note

During vaccination

SIVSO_S_B1

List of Students Withheld Seasonal Influenza Vaccination

SIVSO_D_C2

SIVSO_D_C2(LAIV)

Seasonal Influenza Vaccine Information on Side Effects

- Injectable Vaccine

- Nasal Spray Vaccine

SIVSO_D_C2(2^nd)

Seasonal Influenza Vaccine Information on Side Effects and 2^nd Dose Arrangement

- Injectable Vaccine